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Description Leprosy remains a common cause of peripheral neuropathy in the Indian subcontinent. 1 Clinical manifestations include skin lesions, peripheral nerve involvement in the form of numbness or weakness or painless non-healing ulcers in anaesthetic hands or feet. 2 'Type 1' reactions are typically seen in patients with an unstable immunological response.

Among the various forms of migraine headaches, ophthalmoplegic migraine is an uncommon and rare form, the incidence of which is approximately 0.7 per million. It presents predominantly with headache and ophthalmoplegia. One of more cranial nerves can be affected, however the third cranial nerve is most often affected. As a result, symptoms wise, mydriasis and ptosis are commonly seen. Patients generally recover completely within a few days or weeks, however residual deficits are known to occur in a minority of patients. One of the common generalised epilepsy syndromes is the juvenile myoclonic epilepsy (JME), its prevalence being roughly up to 10% of all patients with epilepsy. It usually begins in the second decade of life. Generalised tonic–clonic seizures myoclonic jerks absences constitute the main seizure types in JME. Studies indicate a definite association of epilepsy with migraine headaches and a significant number of migraneurs are found to be epileptic. Conversely, patients with epilepsy are two times more likely to have migraine, as compared to their first degree relatives without migraine. We report a known case of a female patient of JME having a history of classical migraine with aura presenting to us with headache and ophthalmoplegia. She was extensively evaluated to rule out other causes of isolated third cranial nerve palsy, with all the investigations being negative for any obvious cause. She was treated with non-steroidal anti-inflammatory drugs for the acute attack and was subsequently put on antimigraine medication, propranolol during her hospital stay, with which her ptosis recovered completely after 2 weeks. The patient was later started on tablet divalproex sodium, which the patient continues to take on a long-term basis, especially because of its efficacy as an antimigraine prophylaxis agent and a potent drug against JME.

Ocular myiasis is a rare disease with invasion of the lids, conjunctiva, cornea and, rarely, orbit or globe of the mammalian eye by dipteral larvae.We report a case of a 74-year-old woman with chronic, infiltrating, ulcerative lesion of the left lower eyelid, which was confirmed as basal cell carcinoma subsequently, having ophthalmomyiasis.She was a destitute, living in unhygienic environmental conditions and having poor general health. She developed permanent blindness as a result of ophthalmomyiasis of the left eye. Proper wound care, hygiene and adequate nutrition helped her recover from the illness.

Background and objectives:Posterior capsular opacification is the most common complication after cataract surgery. Nd:YAG laser capsulotomy remains the cornerstone of its treatment. This study is undertaken to assess the visual outcome and complications following Nd:YAG laser capsulotomy and compare the results between diabetics and age- matched normals.Methods:This is a prospective study of 50 patients (25 diabetics and 25 non-diabetics), conducted in Chigateri General Hospital and Bapuji Hospital, attached to J.J.M. Medical College, Davangere. All patients aged 35 years and above, who presented to the outpatient department with visually significant posterior capsular opacification underwent Nd:YAG laser capsulotomy. Patients were followed up on first week and first month and improvement in BCVA and occurrence of complications were assessed.Results:96% patients who underwent Nd:YAG laser capsulotomy for PCO showed improvement in visual acuity. The BCVA at first month (54% had ≥6/12) was found to be better than at first week (44% had ≥6/12). The final BCVA at one month was found to be better in non-diabetics (68% had ≥6/12) compared to diabetics (40% had ≥6/12). 34% diabetics and 36% non diabetic patients showed a rise in IOP at first week follow up and return to baseline values at 1 month follow up, the pattern of change in IOP being similar in both the groups. Corneal damage was noted in 1 patient of the non-diabetic group. 3 diabetics and 3 non-diabetic patients developed iritis. IOL pitting was seen in 2 diabetics and 2 non-diabetic patients. One diabetic patient developed cystoid macular edema. One diabetic patient developed disruption of anterior hyaloid face. More no. of complications were noted in the diabetic group.Interpretation and Conclusion:Nd:YAG laser capsulotomy effectively improves the visual acuity in patients with visually significant PCO. It is associated with a transient rise in IOP. Diabetics are prone to develop more complications like cystoid macular edema. The comparatively poor visual outcome in the diabetic group can be attributed to the associated retinopathy changes.

Among the various forms of migraine headaches, ophthalmoplegic migraine is an uncommon and rare form, the incidence of which is approximately 0.7 per million. It presents predominantly with headache and ophthalmoplegia. One of more cranial nerves can be affected, however the third cranial nerve is most often affected. As a result, symptoms wise, mydriasis and ptosis are commonly seen. Patients generally recover completely within a few days or weeks, however residual deficits are known to occur in a minority of patients. One of the common generalised epilepsy syndromes is the juvenile myoclonic epilepsy (JME), its prevalence being roughly up to 10% of all patients with epilepsy. It usually begins in the second decade of life. Generalised tonic–clonic seizures myoclonic jerks absences constitute the main seizure types in JME. Studies indicate a definite association of epilepsy with migraine headaches and a significant number of migraneurs are found to be epileptic. Conversely, patients with epilepsy are two times more likely to have migraine, as compared to their first degree relatives without migraine. We report a known case of a female patient of JME having a history of classical migraine with aura presenting to us with headache and ophthalmoplegia. She was extensively evaluated to rule out other causes of isolated third cranial nerve palsy, with all the investigations being negative for any obvious cause. She was treated with non-steroidal anti-inflammatory drugs for the acute attack and was subsequently put on antimigraine medication, propranolol during her hospital stay, with which her ptosis recovered completely after 2 weeks. The patient was later started on tablet divalproex sodium, which the patient continues to take on a long-term basis, especially because of its efficacy as an antimigraine prophylaxis agent and a potent drug against JME.